Provider Demographics
NPI:1154322071
Name:SUCHIN, CRAIG R (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:R
Last Name:SUCHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:14 KEYSER WOODS CT
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1615
Mailing Address - Country:US
Mailing Address - Phone:443-895-0666
Mailing Address - Fax:410-363-2860
Practice Address - Street 1:25 CROSSROADS DR STE 110
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5444
Practice Address - Country:US
Practice Address - Phone:410-363-2192
Practice Address - Fax:410-363-2860
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA9835272085R0202X
MDD00651032085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA009835270Medicaid
G68367Medicare UPIN